Provider Demographics
NPI:1972142370
Name:JOHN PAVCO LLC
Entity type:Organization
Organization Name:JOHN PAVCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAVCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-628-2495
Mailing Address - Street 1:1414 BELMONT STREET
Mailing Address - Street 2:#306
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-6636
Mailing Address - Country:US
Mailing Address - Phone:703-628-2495
Mailing Address - Fax:
Practice Address - Street 1:1627 K STREET, NW
Practice Address - Street 2:SUITE 500
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1708
Practice Address - Country:US
Practice Address - Phone:703-628-2495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-02
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty